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In 2016, roughly 7.4 million people over the age of 11 were affected by substance misuse or addiction. Everyone with a substance use disorder has a unique story about how they began to get involved with drugs. While many people with addiction can relate to each other, it’s important to remember that everyone’s experience is personal. Still, most people’s addiction spurred from several phases ranging from their first introduction to their spiral into dependency. Examining the different periods of drug use that eventually lead to addiction can help people understand where recreational drug use ends and where a dangerous substance use disorder begins.
A lot of people experiment with drugs or alcohol before reaching adulthood. The natural curiosity and rebellion of teenagers and young people usually cause the initiation into trying substances for the first time. With the help of some added peer pressure and desire to fit in, young people are most often at the most significant risk of exposure in early life. Because adolescents still don’t have fully developed prefrontal lobes in their brains, their judgment and impulse control is often shaky, making them vulnerable for potential misuse or addiction. A survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) showed that 2.8 million people above the age of 12 used an illicit drug for the first time in 2013. Every day, about 4,220 people under the age of 18 will use drugs and alcohol for the first time.
However, even people who abstained from an early introduction to substance use can still experience this stage later on in life. As adults, we deal with many stressful situations on the job, at home, and even personal struggles with mental health. This can prompt some people to self-medicate with drugs or alcohol, especially when they are emotionally compromised. Even those who are not dealing with personal issues may want to fit in with co-workers, friends, or even family members who may be misusing drugs recreationally. After this first introduction to a substance, people generally will decide to experiment further or decide against it.
Upon the initial first try, drug use can quickly become experimental, occurring more frequently. Some people start this by only using drugs in a specific situation, like a party or during events like concerts. This exploratory phase is usually a more social matter that involves drugs as a way to relax or have some fun. At this point, people generally don’t seem to think about these substances too much other than right before the time they plan to use them. Cravings generally do not exist at this phase, but the anticipation of the social event of using the drug may become a factor. At this time people will decide to consciously consume drugs, understanding the potential consequences, or they will take the drugs impulsively, without much pre-planning. Still, their thoughts and concerns aren’t centered on their drug use, and will only take part when it is convenient.
Recreational drug use is more common than most people realize. Some use drugs to “party,” while others use them to unwind. When someone is regularly buying and ingesting drugs, it qualifies as recreational use that can be as frequent as every weekend or several times a week. At this stage, people are more aware of their intake and usually have a ritual surrounding their methods of obtaining and preparing the drugs. Sometimes they may miss work or school due to the after-effects of using the drugs. This drug use often goes hand-in-hand with people who are looking for drugs to escape their situations or cope with other issues. Others may use drugs regularly because they feel that it makes their social interactions much more exciting and enjoyable. At this point, they prefer to use drugs socially rather than stay sober.
When someone enters this phase, their drug use is considered to be risky and has become a problem. People that are misusing substances will sometimes have run-ins with dangerous situations like DWIs or other negative legal consequences. Their performance at work or school will be dwindling, and their relationships with loved ones are negatively impacted by their frequently unpredictable behavior. When someone is misusing drugs, they are beyond the point of regular recreational use and are walking the fine line between risky use and a substance use disorder. This is often the stage where people will first be approached by someone concerned about their frequent intoxication.
Drug dependency can be split into three parts: tolerance, physical dependence, and psychological dependence. When someone builds tolerance, they will require more and more of the drug they are misusing to achieve the desired effect. When a physical dependence occurs, it means that the person will go through withdrawal responses when they aren’t able to ingest their drug of choice. These withdrawals can range from light cravings to severe symptoms that can leave the user in significant pain. Psychological dependence happens when cravings are not only controlled by painful or bothersome withdrawals, but by the mental drive to use drugs. Some people who prefer to be ‘high’ constantly or under the influence are not able to face simple day-to-day tasks without their drug and require it to function. These three steps are cumulative and usually progress within several weeks or months of each other depending on the frequency of use.
When someone’s drug use has spiraled out of control, they will experience the following symptoms to fit the SUD criteria:
Addiction is a disease that has developed from these long phases of drug use, carefully rewiring the brain’s reward pathway to constantly prioritize drug use over all else. Even when this person has attempted to cease their drug use, they have been unsuccessful and experienced dangerous relapses, returning to their previous behaviors. Usually, at this phase, people rarely can feel the high they once desired and continue to use the drug to keep withdrawal at bay.
The last stage of the substance use disorder progression is treatment, remembering however that treatment can begin at any phase of drug use. There are several treatment options for people who are faced with addiction that involve medication, behavioral therapy, and other counseling to help get them on the road to recovery.
Sources: https://www.stanfordchildrens.org/en/topic/default?id=stages-of-substance-abuse-1-3060
https://www.drugs.ie/drugs_info/about_drugs/the_nature_and_states_of_drug_use/
